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Legislative Updates displays bills pending in the 2018 state legislative sessions. Some bills were carried over from 2017, while others were filed in 2018. It is updated weekly. To view bills from the 2013-2014 and 2015-2016 sessions and their results, see Legislative Archive. A Legislative Archive for 2017 bills that have been resolved will appear soon.

Bills are listed by state and subject, with a brief explanation of what's in the bill. Unless indicated otherwise, we believe the listed bills should not pass. Unfortunately, most CAM bills filed in the state legislatures are pro-CAM. Bills added to the list this week, or with updated information, are marked NEW!

To voice your opinion on these bills (and we hope you will) you need to find out where they are in the legislative process and how to contact state legislators in the states where they are pending. See FAQS for more information on how to do this. Each year there are many bills forcing public and private health insurance providers to cover CAM services (especially chiropractic). Because of the sheer volume of these bills we are unable to include them in our legislative updates at this time.

ALASKA: Senate Bill 120, House Bill 326. SB 120 to Senate Comms. on Labor & Commerce and Finance; HB 326 to House Comms. on Finance and Labor & Commerce.Major practice expansion. Alaska naturopaths currently have a fairly narrow scope of practice. This bill would allow naturopaths to diagnose or treat any patient of any age with any disease or condition via "support and stimulation of an individual's inherent self-healing processes," i.e, vitalism, a long-discredited prescientific notion that a supernatural force guides human bodily functioning. Nevertheless, naturopaths would be able to prescribe drugs (except controlled substances and chemotherapy), perform minor office surgery, perform and order diagnostic testing, which would permit them to employ the sort of quack tests typical of naturopathic practice and diagnose fake diseases like "adrenal fatigue" and "chronic candidiasis." Naturopathic education and training are insufficient to allow them to safely practice primary care, which is essentially what this bill allows, especially prescription privileges.

COLORADO: House Bill 1068. Passed House; to Senate. Colorado allows naturopaths to register, but does not license them. Last year, the Colorado General Assembly passed a law requiring naturopaths to use the term “Registered Naturopathic Doctor” to avoid public confusion. The naturopaths do not like this, so this year they got a bill introduced eliminating the requirement.

HAWAII: NEW!House Bill 1949, Senate Bill 2299. HB 1949 passed in Judiciary and Health & Human Services Comms. with request that naturopaths address concerns about use of testosterone in "anti-aging" and side effects before Interstate Commerce Comm. which has scheduled a hearing for 2/14/18. Senate Comms. on Commerce (etc.) and Public Safety (etc.) recommend passage. Once again, naturopaths are seeking the authority to prescribe testosterone. Both bills describe naturopaths as experts in “bio-identical hormones.” “Bio-identical hormones” is a marketing, not a medical, term, and their prescription is not recommended by experts. Naturopaths do not have the education and training to prescribe, a fact that even the North American Board of Naturopathic Examiners has admitted. Their knowledge of endocrinology is insufficient as well.

ILLINOIS: Senate Bill 708; House Bill 2530. SB 708 postponed Senate Comms. on Assignments and Licensed Activities & Pensions, rereferred to Assignments Comm. HB 2530 referred House Comm. on Health Care Licenses, rereferred to House Comm. on Rules. Licensing bill. Similar to failed bills introduced in past legislative sessions, SB 708 and HB 2530 do not define the scope of practice for naturopathic "doctors," who must have graduated from a naturopathic "medical" school and passed the NPLEX. Would be regulated by state board of medicine, to which one naturopathic member would be added. Would be allowed to call themselves naturopathic "physicians."

INDIANA: House Bill 1427. Indiana does not currently license the practice of naturopathy. This licensing bill would allow a broad scope of practice, similar to that of a primary care physician, in that naturopathic “doctors” could diagnose and treat any patient of any age with any disease or condition. They would be limited only in the diagnostic methods and treatments they could employ. Treatments include manipulation, colon hydrotherapy (which is quackery), botanicals, homeopathy (also quackery), dietary supplements (which are poorly regulated and have insufficient evidence of safety and efficacy), “nutraceuticals” and nonprescription drugs, using routes of administration that include vaginal, rectal and intramuscular. Would be allowed to prescribe drugs, including controlled substances, approved by a Board of Naturopathic Medicine, consisting of 5 naturopaths and two public members, and could administer these prescription drugs via intradermal, subcutaneous or intravenous routes of administration. Could order and perform diagnostic testing, including phlebotomy, lab tests (naturopaths often use bogus lab tests to diagnose fictional diseases and conditions), and electrocardiograms, and order and interpret the reports of diagnostic imaging studies. Licensees could practice after graduating from naturopathic school without having done any internship or residency and passing NPLEX exam. For the reasons why naturopathic “doctors” should not be licensed seeKey legislative points pertaining to the licensing and regulation of practitioners of naturopathic medicine in North America; for a look at naturopathic diagnostic methods and treatments see Naturopathic Diaries; for a review of the insufficiency of their education and training to prescribe drugs, see A Report based on the Committee on the Practice of Naturopathy (Connecticut; accessible here) and Naturopathic scope of practice expansion killed in North Dakota; for a discussion of the ethical issues regarding in-office sales of dietary supplements and other remedies, see In-office sales is an ethical problem for naturopathic medicine.

NEW YORK: Senate Bill 4297, Assembly Bill 5913. SB 4297 referred to Senate Comm. on Higher Education; AB 5913 referred to Assembly Comm. on Higher Education. This will be the ninth consecutive legislative session a licensing bill has been introduced.Gives naturopaths a broad scope of practice "to address the shortage of primary care physicians." Is based on the fiction that naturopaths can stimulate the "inherent property in a living organism to heal itself," i.e., vitalism. Would allow naturopaths to diagnose and treat any patient of any age with any disease or condition. Allows the use of bogus "CLIA-waived" tests, including diagnostic tests that have never been validated, which they use to diagnose fake diseases. Naturopaths would be able to prescribe worthless homeopathic remedies, dietary supplements, herbs, thyroid hormones, estrogen, progesterone and DHEA, which they would be able to administer by all the usual routes (vaginal, rectal, oral) and, if registered with the state, by injection, including IV administration. This would permit them to concoct dubious remedies like Myers cocktails, high dose vitamin C and other substances and administer them intravenously. Could order diagnostic imaging, including MRIs and thermography, and perform cryotherapy, ligation, fulguration, other minor office procedures and colonics. Would be regulated by a naturopathic board consisting of six naturopaths, two public members and one MD or DO. If bill passes, after two years naturopaths would have to have completed a one-year "residency" to become licensed.

NORTH CAROLINA: Senate Bill 258; House Bill 692. SB 258 to Senate Comm. on Rules; HB 692 to House Comm. on Finance. This will be the 8th consecutive legislative session in which a naturopathic regulatory bill has been introduced. The latest attempt creates "certification" for naturopaths but otherwise gives them the scope of practice they generally want to start with before coming back to the state legislatures year after year to expand their scope, as the current and archived Legislative Updates demonstrate they regularly do. Naturopaths who've graduated from an accredited naturopathic school and passed the NPLEX would be allowed to diagnose and treat any patient of any age with any condition or disease, no matter how complex. They could order and dispense (read: sell) "natural" remedies, including food, "nutraceuticals," dietary supplements and homeopathic remedies. They could employ their quack diagnostic tests and order diagnostic imaging (fortunately, interpretation of imaging would be left to professionals). They would be able to use oral, nasal, rectal and vaginal routes of administration; injections and IVs are neither excluded or included. Would be regulated by a Naturopathic Doctors Certification Board, with a majority of the board being naturopaths. No malpractice insurance is required and no prohibition against substandard care (only "gross negligence") or false advertising is contained in the bill.

NORTH CAROLINA: House Bill 277. Original bill dealt with prescription drug abuse committee and passed House as such; Senate Health Care Comm. substituted totally different language and passed; now before Comm. on Rules & Operations of the Senate. Would establish a "work group" to study "the appropriate oversight and regulation" of naturopathic practice in North Carolina, although the game seems rigged in favor of licensing by commanding the work group to "identify an approved study of naturopathic medicine" but which defines same so that only one outcome can be reached, that being the current system of self-regulated naturopathic schools which teach homeopathy, "detoxification," anti-vaccination ideology and other pseudoscience. The work group would consist of two naturopaths appointed by the North Carolina Association of Naturopathic "Physicians," two MDs (one of whom must have experience working with naturopathic doctors) and a designee of the state Secretary of Health.

OKLAHOMA: Senate Bill 1518. Licensing bill. Would allow naturopaths to call themselves “naturopathic physicians” and diagnose and treat any patient of any age with any disease or condition. Describes naturopathy as “primary health care.” Would be regulated by osteopathy board, advised by a Naturopathic Medicine Committee. Although the bill provides for the creation of a naturopathic formulary of prescription medicines, and defines “minor office procedures” and “approved substances” (which includes homeopathic remedies and dietary supplements), the bill does not specifically define naturopathic practice to include either of these or drugs on the formulary. Presumably the osteopathic board’s regulations will address these matters. For the reasons why naturopathic “doctors” should not be licensed seeKey legislative points pertaining to the licensing and regulation of practitioners of naturopathic medicine in North America; for a look at naturopathic diagnostic methods and treatments see Naturopathic Diaries; for a review of the insufficiency of their education and training to prescribe drugs, see A Report based on the Committee on the Practice of Naturopathy (Connecticut; accessible here) and Naturopathic scope of practice expansion killed in North Dakota; for a discussion of the ethical issues regarding in-office sales of dietary supplements and other remedies, see In-office sales is an ethical problem for naturopathic medicine.

PENNSYLVANIA:Senate Bill 834. Referred to Senate Consumer Protection & Professional Licensing Comm. Just last year, Pennsylvania passed a naturopathic registration act, allowing naturopathic "doctors" to register with the state, without defining a scope of practice and leaving the details up to the state medical board, under whose jurisdiction naturopaths would practice. As predicted, this was simply a "foot-in-the-door" strategy and naturopaths are already back before the General Assembly with a licensing bill that would allow them to diagnose and treat any patient with any disease or condition, although they would still operate under the jurisdiction of the medical board. As is typical, the licensing bill defines naturopathy as vitalism ("to support and stimulate the individual's intrinsic self-healing processes," a long-discredited, pre-scientific notion of human bodily functioning. Naturopathic "doctors" with four-year degrees from naturopathic "medical schools" who pass the NPLEX could perform and order diagnostic testing, order diagnostic imaging studies, and prescribe dietary supplements, homeopathic remedies, herbs, and other nostrums of dubious efficacy and safety, like colonic irrigation. They would be required to have $1 million in malpractice insurance and must refer a patient "presenting a contradiction to naturopathic medicine" to a physician. They could not prescribe drugs or perform surgery and cannot call themselves "physicians."

WASHINGTON: Senate Bill 5369. Referred to Senate Comm. on Health Care. Practice expansion bill. Would expand authority to prescribe controlled substances to include all Schedule III, IV, and V controlled substances with additional education requirements determined by the naturopathic board. Currently, the board permits limited controlled substances prescribing with only 4 hours of additional education. Board would also be given exclusive authority to determine what minor office surgery naturopaths could perform and what are cryptically described as "other nutrients, compounds, and natural substances" naturopaths could prescribe and sell to patients. Would allow naturopaths to sign "guardianships, powers of attorney, disability determinations, and similar legal documents."

Chiropractic

ALABAMA: NEW!House Bill 136; Senate Bill 234. HB 136 reported favorably out of House Comm. on Insurance; SB 234 passed Senate, to House. Would allow chiropractors to enter into direct payment agreements with patients, but does not, unlike a new Tennessee law or a bill pending in Florida (see below), permit chiropractors to call these “direct primary care agreements,” falsely implying that chiropractors can provide primary care as that term is commonly understood.

FLORIDA: Senate Bill 80; House Bill 37. Bills include chiropractors among those who can enter into direct primary care (DPC) agreements with patients. Under DPCs, patients pay a fixed amount for specified services. Passage of these bills will predictably result in (1) chiropractors signing patients up for regular “adjustments” of non-existent “subluxations” for “wellness” and (2) chiropractors (aided by the term “direct primary care agreement”) convincing patients that they should be the first stop for all their health care needs, in accordance with the chiropractic industry’s push to rebrand themselves as “primary care physicians.” For more information, see Science-Based Medicine’s series on the “DC as PCP.”

INDIANA:House Bill 1384, Senate Bill 160. HB 1384 passed House, to Senate. Major practice expansion bills. Chiropractic is currently defined as diagnosis and treatment of “interference with normal nerve transmission,” i.e., traditional subluxation-based chiropractic. Bill would allow examination and treatment of all human ailments as long as no surgery or prescription drugs are used. Removes prohibitions on use of ionizing radiation, conducting invasive diagnostic testing and analysis of bodily fluids, and prohibitions on treatment of infectious diseases, endocrine disorders, or atypical or abnormal histology. Allows the use of any therapy to treat any “injury, condition or disorder” as long as the therapy is taught in a chiropractic college or in an approved postgraduate program. Such programs could include "chiropractic pediatrics" and "chiropractic internal medicine." Chiropractors could prescribe and sell dietary supplements to patients to treat illness under the guise of “nutritional counseling.” Under Senate Bill, can order, perform, and interpret laboratory, radiological, electrodiagnostic or “any other diagnostic study,” including ordering x-ray and advanced diagnostic imaging of the entire human body, while under House Bill, they could perform any "therapeutic procedure or service not beyond [their] education and training" including ordering and interpreting results of advanced imaging and x-rays.

MARYLAND: Senate Bill 164. Hearing scheduled for 2/15/18 at 1 pm before House Comm. on Ways & Means. This is chiropractic practice-building disguised as a public health initiative. Would require certain measures be taken to educate parents and students about the dangers of heavy backpacks. Requires inclusion of information from “trained medical personnel.” Permits county education boards to implement policy allowing chiropractors to perform scoliosis exams on students. Chiropractors will presumably become the “trained medical personnel” who provide the required information, thereby allowing them to advertise their services to parents and promote chiropractic treatment of pediatric patients. Routine screening for scoliosis is controversial. The Scoliosis Research Society, American Academy of Orthopedic Surgeons, Pediatric Orthopedic Society of North America and American Academy of Pediatrics believe that “screening examinations for spine deformity should be part of the medical home preventative services visit for females at age 10 and 12 years, and males once at age 13 or 14 years” and do not endorse routine screenings of the type described in this bill. Chiropractic treatment of scoliosis is not recommended by the Scoliosis Research Society and spinal manipulation for scoliosis is generally not covered by insurance.

MISSOURI: Senate Bill 746, House Bill 1911. HB 1911 to House Comm. on Agriculture Policy. Permits the practice of animal chiropractic by veterinarians and chiropractors. Animal chiropractic is described in traditional subluxation-based terms, referring to the “vertebral subluxation complex.” Chiropractic subluxations have never been shown to exist in either humans or animals. Unsurprisingly, therefore, there is no reliable way to detect these subluxations, treat them, or any evidence that treatment has a positive effect on health.

NEW YORK: Assembly Bill 8541, Senate Bill 7247. AB 8541 to Assembly Comm. on Higher Ed. Practice expansion bill. These poorly-worded bills substitute one pseudoscientific definition of chiropractic for another. Current law allows chiropractors to remove "nerve interference" via the detection and correction of "subluxations." These bills allows chiropractors to diagnose "the human body" for "any human disease, pain, injury, deformity or physical condition" by detecting and correcting "subluxations." Of course, the chiropractic "subluxation" does not exist and the entire premise of the bill is based on a fiction. Would permit chiropractors with vaguely described additional training to to engage in "wellness care methods" and give dietary and nutritional advice, including dispensing dietary supplements. Bills would also expand chiropractors right to use lab testing and electrodiagnostic testing, as well as perform manipulation under anesthesia. Would allow allow chiropractors to call themselves chiropractic "physicians." These provisions are typical of the American Chiropractic Association's campaign to rebrand chiropractors as "primary care physicians" and "chiropractic internists."

WISCONSIN: NEW!Assembly Bill 260; Senate Bill 232. AB 260 passed Assembly, to Senate; SB 232 & AB 260 referred to Senate Comm. on Health & Human Services, which adopted amendment to AB260 deleting right to perform physicals, but full Senate will need to vote on amendment. Practice expansion bill. Would allow chiropractors to perform physical exams for student athletes, including college athletes. Requires chiropractor to hold "certificate in health or physical examinations" but the education, training and any other requirements for these certificates would be solely up to the chiropractic board. Many groups oppose the bill, including the Wisconsin Medical Society, which rightly pointed out that chiropractors aren't qualified to examine students for cardiovascular problems, mental health, and substance abuse issues, among others. Also opposed by several medical specialty groups, the state nurses and athletic trainers associations, hospitals, insurance groups and "straight" chiropractors. Harriet Hall, MD, herself a retired family practice physician, explained why chiropractors aren't qualified to perform sports physicals on Science-Based Medicine. Bill would have allowed the practice of something called "chiropractic acupuncture," which is opposed by acupuncturists, but Assembly amendments stripped these provisions from AB 260.

Acupuncture, Traditional Chinese Medicine and Oriental Medicine

MASSACHUSETTS: House Bill 3247. Heard 11/07/2017 before Joint Comm. on Public Health; in Joint Comm. on Health Care Financing; eligible for Executive Session. There is a turf war going on between acupuncturists and physical therapists over the practice of "dry needling." Acupuncturists claim dry needling is the practice of acupuncture and is not within the scope of practice of physical therapists. This bill defines the insertion of filiform needles as acupuncture, thereby settling the issue in favor of acupuncturists and effectively preventing physical therapists from performing dry needling unless it is added to the PT practice act.

MICHIGAN:Senate Bill 683. Referred to Senate Comm. on Health Policy. Acupuncture licensing and scope of practice expansion bill. Michigan currently allows acupuncturists to register with the state and limits their practice to needle acupuncture. SB 683 would allow acupuncturists to become licensed and vastly expand their scope of practice to include laser acupuncture, electroacupuncture and dry needling as well as "dermal friction" (gua sha), cupping, prescribing herbal remedies, and homeopathy (which has nothing to do with Traditional Chinese Medicine). Acupuncturists will be able to diagnose and treat any disease or condition in patients of any age using "traditional and contemporary East Asian medical theory." Would also allow the practice of auricular acupuncture for substance abuse treatment by anyone with a certification from the National Acupuncture Detoxification Association practicing under the supervision of a acupuncturist or physician. (NADA auricular acupuncture has never been proven effective for substance abuse.)

OKLAHOMA: NEW!Senate Bills 1119, 1501, 1523. SB 1119, 1501 & 1523 to Senate Comm. on Health & Human Services. Oklahoma is one of the few states that does not license acupuncturists. Three different licensing bills have been introduced in the state Senate. SB 1119 and 1501 contain similar provisions, permitting needle acupuncture for “promoting, maintaining and restoring health” even though acupuncture has not been proven to do any of these things, including alleviation of pain. Permits the practice of National Acupuncture Detoxification Association (NADA) “auricular acupuncture” for treating mental and emotional health, post and acute trauma, substance abuse, and chemical dependency. The proposed mechanism of action for “auricular acupuncture” is highly implausible and NADA’s promotion of it for substance abuse and other conditions is based on an unpublished and cherry-picked review of the evidence. Acupuncture Board would regulate acupuncturists. SB 1523 goes even further, describing acupuncture as “primary health care” and allowing acupuncturists to diagnose (using fanciful methods like tongue and pulse diagnosis) and treat for same purposes as other bills as well as “disease prevention.” Acupuncturists can, in addition to needle acupuncture, employ moxibustion, herbal therapies, and “other adjunctive properties.” Also permits the practice of “Oriental medicine.” Under SB 1523, regulation would be under the state osteopathic board in consultation with an acupuncture committee.

WEST VIRGINIA: NEW! House Bill 4465. To House Health & Human Services Comm. Authorizes state acupuncture board to issue certificates to "auricular acupuncture detoxification specialists" trained in the National Auricular Acupuncture Detoxification Association (NASA) protocol to perform "auricular acudetox" for the treatment of substance abuse, alcoholism, chemical dependency, detoxification, behavioral therapy and trauma recovery. The proposed mechanism of action for “auricular acupuncture” is highly implausible and NADA’s promotion of it for substance abuse and other conditions is based on an unpublished and cherry-picked review of the evidence.

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